The existing Vanderbilt Newborn Lung Center SCOR program is made up of a group of interdependent studies of the etiology, pathogenesis, management and sequelae of hyaline membrane disease (HMD). Specific studies deal with the development and control of the surfactant system and include investigations of the direct pulmonary effects of Vitamin A, epidermal growth factor (EGF) and ACTH. Circulatory mechanisms in the pathogenesis of HMD are being investigated by studies of pulmonary vascular permeability, the distribution of lung fluid, and the influence of the prostaglandins system during transition from fetal circulation. Identification of factors that influence the outcome of HMD and improved clinical management is sought by using computer and statistical techniques to model and predict the course of this disease. The long-term pulmonary and developmental outcome of infants with HMD is assessed by systematic follow-up studies. Five supplementary requests are made to augment this SCOR program. In response to the emergence of Group B streptococcal (GBS) sepsis and pneumonia as a principal cause of morbidity and mortality of newborn infants, an investigation of the pulmonary vascular effect of GBS and its blockade has been designed. Validation of impedance cardiography as a non-invasive means to measure pulmonary blood flow in infants with HMD is the objective of the second new project. The third proposal will enhance the scope of EGF studies by making available purified human EGF. The fourth project is proposed to incorporate serial lung compliance measurements into the computer modeling of the course of HMD. The fifth supplementary request is made to replace an old and frequently inoperative polygraph which is essential to the SCOR physiological studies.